Carnitine Deficiency: What Is It, Causes, Symptoms, and More Osmosis Carnitine metabolism in hypertensive heart failure Hypertension Research L Carnitine & Arterial Plaque L Carnitine with Chromium Wycoff Wellness L carnitine is primarily synthesized in the liver from the amino acids lysine and methionine through a series of four enzymatic reactions, with the liver and kidneys converting the precursor butyrobetaine into active